Childhood maltreatment as a risk factor for arthritis: Findings from a population-based survey of Canadian adults
Authors: Elizabeth M. Badley, Margot Shields, Siobhan O'Donnell, Wendy E. Hovdestad, and Lil Tonmyr
Objective To establish whether there is a relationship between the frequency and severity of different types of childhood maltreatment and adulthood arthritis. Methods Analysis of the 2012 Canadian Community Health Survey–Mental Health included 21,889 respondents ages => 18 years. Severity and frequency of childhood physical abuse (CPA), and childhood sexual abuse (CSA), and the frequency of childhood exposure to intimate partner violence (CEIPV) were assessed by asking about “things that may have happened to you before you were 16 in your school, in your neighborhood, or in your family.” Respondents were also asked about chronic conditions diagnosed by a health professional, including arthritis. Covariates were sociodemographic characteristics, health risk variables (e.g., obesity), mental disorders, and a count of other chronic conditions. Multivariate logistic regression analysis was used to examine associations between childhood maltreatment and arthritis. Results A total of 17.5% of respondents reported arthritis. A higher prevalence of arthritis was observed for those who had experienced severe and/or frequent childhood maltreatment (32% for CPA and 27% for both CSA and CEIPV). These relationships persisted after controlling for sociodemographic variables. After controlling for all covariates, arthritis remained independently associated with severe and/or frequent CPA (dose-response relationship) and frequent CEIPV. Conclusion We found that the greater the frequency and severity of childhood maltreatment, the greater the magnitude of association with arthritis. This might reflect the role of the enduring immune and metabolic abnormalities and chronic inflammation associated with childhood maltreatment in the etiopathogensis of osteoarthritis (OA) or be an indicator of the role of joint injury in causing OA.
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